MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

Back

Facility Information

Facility Name
HITSMAN, MICHELLE ANN

Facility DVN
000809110

Phone
(660) 888-9927

Physical Address
1053 HWY 5 & 240
FAYETTE
MO 65248

Owner
HITSMAN, MICHELLE ANN

Mailing Address

Provider/Director
HITSMAN, MICHELLE ANN

E-mail Address
michellehitsman@hotmail.com

Incorporated

Child Care Specialist
LU A GAINES

Age Range
BIRTH - 9 YEARS

Capacity
10

Facility Type
FAMILY HOME

Limitations
IF ONLY 4 CHILDREN PRESENT, ALL CHILDREN MAY BE UNDER AGE 2 WITH 1 ADULT CAREGIVER; UP TO 10 CHILDREN IN CARE NO MORE THAN 2 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER; UP TO 10 CHILDREN IN CARE NO MORE THAN 4 CHILDREN UNDER AGE 2 WITH 2 ADULT CAREGIVERS; UP TO 6 CHILDREN IN CARE NO MORE THAN 3 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER

Inspection Information

Date
03/21/2024

Arrival Time
2:50 PM

Departure Time
3:20 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2466890485

Document	Document-Date
ASSISTANT APPROVAL REQUEST	04/02/2012
SAFE SLEEP POLICY	01/21/2016
DISASTER AND EMERGENCY PREPAREDNESS PLAN	02/10/2012
OWNER/PROVIDER REFERENCES	07/28/1997
DAILY SCHEDULE	06/30/1997
CHILD CARE/DISCIPLINE POLICIES	06/30/1997
POLICIES	06/30/1997
SAMPLE WEEKLY MENU	06/30/1997
DIAGRAM/INDOOR	08/31/1998
DIAGRAM/OUTDOOR	08/31/1998
LOCAL FIRE DEPARTMENT NOTIFICATION	08/17/2018
ASSISTANT REFERENCES	09/12/2018
APPLICATION	05/15/2020
FIRE/SAFETY INSPECTION	06/12/2023
SAMPLE FORMS	04/13/2022
SANITATION INSPECTION	06/12/2023
EQUIPMENT LIST	06/29/2023
ANNUAL DECLARATION	06/07/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	06/29/2023

Overlap Start Time	Overlap End Time	Overlap Submit Date
11:00AM	12:00PM	12/5/2022
4:00PM	5:00PM	12/5/2022

Inspection determined facility to be in compliance with licensing rules.

Open Violations: NA

NOTE

The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.

Attendance at Time of Inspection

Total Staff 1

Total Children 8

Staff	Child	Class Age	Note
1	8	MIXED	Provider Michelle Hitsman present on site with two children ages 6 months - 19 months old, One child 2 years of age, and five children ages 3 - 5 years old.


5 CSR 25-400.025 Organization and Administration Compliance
5 CSR 25-400.045 Licensing Process Compliance
5 CSR 25-400.055 Annual Requirements Not Observed
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home Compliance
5 CSR 25-400.086 Fire Safety Compliance
5 CSR 25-400.090 Disaster and Emergency Preparedness Compliance
5 CSR 25-400.095 Furniture, Equipment and Materials Compliance
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel Compliance
5 CSR 25-400.115 Child Care Family and Household Compliance
5 CSR 25-400.125 Medical Examination Reports Not Observed
5 CSR 25-400.135 Admission Policies and Procedures Compliance
5 CSR 25-400.145 Nighttime Care Not Observed
5 CSR 25-400.155 Overlap Care of Children Not Observed
5 CSR 25-400.165 Emergency School Closings Not Observed
5 CSR 25-400.175 Child Care Program Compliance
5 CSR 25-400.185 Health Care Compliance
5 CSR 25-400.190 Nutrition and Food Service Not Observed
5 CSR 25-400.200 Transportation and Field Trips Not Observed
5 CSR 25-400.210 Records and Reports Not Observed
5 CSR 25-600.020 General Requirements Not Observed
5 CSR 25-600.040 Background Screening Findings Not Observed
RSMo 210.115. Reports of abuse, neglect, and under age eighteen deaths - persons required to report - supervisors and administrators not to impede reporting - deaths required to be reported to the division or child fatality review panel, when - report made to another state, when. Compliance
RSMo 210.211. License required - exceptions - written notice of licensure status, when. Compliance
RSMo 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized. Compliance